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4. 2023-24 School's Out/Afterschool Sliding Fees Application

   This form is for Afterschool and School's Out programs only. For all other programs, use the Share The Fun grant application.

   NEW INCOME GUIDELINES FOR THE 2023-24 SCHOOL YEAR
   Families whose income falls within the guidelines listed below qualify for sliding fees funded by the City of Missoula, Missoula County and community donations. Please complete this form BEFORE REGISTRATION so we can attach the correct discount level to your Webtrac account. Income levels and fees are listed below.

   Valid for Afterschool and School's Out programs, 2023-24 school year only. Due to funding constraints, last year's "Orange" sliding fee pass has been discontinued.

   Registration opens Sunday, August 6, at 9 a.m. After completing this form, we will email information about how to register for programs within two business days. Information provided will remain confidential. Questions or concerns? Use the comment box below, call 406-721-7275, or email parksrec@ci.missoula.mt.us. Sliding fees available through 05/31/2024.

   SHARE THE FUN!
   Donate any amount to support recreation and aquatics grants for families who need financial assistance. Your contribution allows us to serve more Missoula families. Or check out the Parks and Recreation license plate—100% of proceeds fund recreation and aquatics grants. Thank you!

6. *NOTE: FOR LOWELL & FRANKLIN FAMILIES ONLY

   Lowell and Franklin families: Complete this form if you need sliding fees for School's Out Camp ONLY. You do not need to complete this form for Afterschool programming. Click to learn more about registering for Lowell or Franklin afterschool.

8. PARENT OR GUARDIAN First Name*
9. PARENT OR GUARDIAN Last Name*
11. Street Address*
12. Email*
14. City*
15. State*
16. Zip*
17. Phone*
19. Do you know your Webtrac online registration login and password?*

    1. Yes.
    2. No, please send.
20. School my child/children attend:
    -- Select One --Chief CharloFranklinHawthorneJeannette RankinLewis and ClarkLowellMissoula International SchoolPaxsonRattlesnakeRussellOther

    Please note: This information is for demographic purposes only. Afterschool pickup is not available at every school. Program details.

22. Please list participant names and birthdates
    Members of your household only, please. List additional children in the box below.
24. Participant Name*
25. Birthdate*
    mm/dd/yy
27. Participant Name
28. Birthdate
30. Participant Name
31. Birthdate
33. Participant Name
34. Birthdate
36. Additional children in household
    First and last names, birthdates
37. Based on the income chart below, my family qualifies for:*

    1. Green Pass Sliding Fee
    2. Purple Pass Sliding Fee

    Proof of income not required. If you require additional assistance to meet your childcare needs, please contact us at 406-552-6657 or email parksrec@ci.missoula.mt.us. No child will be turned away due to inability to pay.

39. 
41. Comments, Questions, Concerns?
43. Signature*

    By electronically signing this form, I certify the above information is accurate and my child/children will comply with program health and safety rules.

45. Learn more about School's Out/Afterschool Programs
    School's Out/Afterschool Programs Info Sheet
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field